Optimal timing of the second caesarean section and possible difficulties. Repeated surgical births

Circumstances during childbirth are not always successful. There are times when a baby cannot be born naturally. Sometimes doctors are forced to do everything possible to save the life of the child and mother. In particular, with the help of a caesarean section. Such an intervention does not go without consequences, and often during a subsequent pregnancy, specialists have to prescribe a second caesarean section. In what cases can you do without it and how to prepare for the upcoming procedure?

Indications for the operation

The decision to repeat the operation is made only after analyzing the various factors that accompany pregnancy. First of all, the state of health of the expectant mother is taken into account - in particular, pathologies such as asthma, hypertension, diabetes mellitus, oncology, serious vision problems, recent traumatic brain injury, a deformed or very narrow pelvis, disorders of the central nervous or cardiovascular systems , the age of the woman in labor after 30 years.

No less important are the features of the seam from the previous operation. The second caesarean section is performed if there is a longitudinal suture and connective tissue in the scar area, its condition is doubtful, and also if there is a risk of the old suture divergence. Also, an indication for the appointment of surgical intervention are abortions after the first cesarean.

Pathologies of pregnancy are also taken into account: overmaturity, large size or incorrect location of the fetus, weak labor activity. A second cesarean is also scheduled if less than two years have passed since the first.

If at least one of the above factors takes place, a second operation cannot be avoided. In other cases, the specialist may allow you to give birth naturally.

The dangers of a second caesarean section

After repeated surgical intervention in the small pelvis, an adhesive process occurs, and scars form on the uterus. Unfortunately, modern medicine does not make it possible to avoid such complications. This often results in bleeding that is difficult to stop. Sometimes a surgeon has to perform a hysterectomy (removal of the uterus) to save a woman's life. As a result, the ability to bear children is lost. Even if you do not resort to such measures, after the second cesarean, the probability of becoming pregnant and bearing a child is only 40%.

A second operation has the risk of damage to the intestines and bladder, since the tissue connections between these organs are broken when the first scar heals. Approximately 1/3 of patients have complications such as inflammatory and infectious processes in the urinary tract. Also, the second caesarean section leads to an increase in morbidity and the development of a woman's immunodeficiency.

The operation also poses a certain danger for the baby: from the moment the caesarean section begins until the baby is born, more time passes than during the first delivery. As a result, for a long time he is exposed to potent drugs.

In addition, there remains the danger of asphyxia (suffocation) of the baby. During natural childbirth, an active launch of all vital systems of the newborn takes place. With a second caesarean section, this does not happen, since the date of the procedure is set before the start of natural childbirth.

In the course of observations, it was found that children who were born by caesarean section experience certain difficulties in adapting to the environment in the first days of life.

Preparation and recovery after surgery

If you are shown a planned reoperation (that is, the need for it was identified during pregnancy), you need to know how to prepare for the upcoming procedure. This will allow you to set yourself up for a successful outcome, calm down, put your body and health in order.

Throughout your pregnancy, try to regularly undergo examinations by a gynecologist, attend prenatal courses that are dedicated specifically to caesarean section. Prepare mentally for the fact that you will have to stay in the hospital for a long time. Think in advance about who you will leave your older children, home, and pets to during this period. Consider the possibility of partner childbirth. If the operation will take place under local anesthesia, during which you will be awake, you will be more comfortable if your life partner is nearby at this moment. Do not hesitate to ask the doctors any questions that interest you (how long is the second caesarean section, what tests are prescribed, what drugs you will need in case of any complications). Find out what kind of anesthesia you will be given. If you want to see the moment the baby is born, ask for local anesthesia.

If by the time of the scheduled date of the operation you will not go to the hospital, prepare things for the hospital: necessary documents, toiletries, clothes and slippers. Two days before surgery, you should stop eating solid food.

Get a good night's sleep. Take a bath the day before going to the hospital. Remove your nail polish and make-up to make it easier for the doctor to monitor your condition during the procedure. For 12 hours you can not drink or eat: this is due to the anesthesia that will be used. If vomiting opens under anesthesia, the contents of the stomach will enter the lungs.

Recovery after a repeated caesarean is not only longer, but also harder. The tissues are cut twice in the same place, so they heal longer than the first time. Within 1-2 weeks, the suture may ooze and hurt. The uterus also contracts longer, causing discomfort.

If you find out that you are about to have a second caesarean section, do not panic. Subject to close cooperation with the doctor, strict adherence to all his recommendations and careful preparation for the operation, it will pass without complications.

A second caesarean section is often given to women who have had a baby through surgery. This operation is performed for medical reasons. The assessment of the condition of the expectant mother is carried out by a doctor in the second trimester. Some patients give birth in this way of their own free will, but this situation is rare.

The determination of the timing of the surgical intervention is carried out by a specialist. The doctor assesses the general characteristics of the patient's health and the presence of indications for a caesarean section. It is also necessary to consider the health of the fetus. If the child has various health problems, then the woman is scheduled for a second caesarean section.

A caesarean section is scheduled for the second time according to the presence of indications. Often this procedure is performed after childbirth, which took place with surgical intervention.

In this case, there is scar tissue on the uterine wall. The scar is made up of cells that change the properties of the tissue. In the damaged area, the walls are not amenable to reduction, and there is also a lack of elasticity.

The operation is also performed with large fetal sizes. If the estimated weight of the child exceeds 4.5 kg, surgery is necessary. In this case, the pelvic bones cannot move apart to a sufficient size. The fetus may become stuck in the birth canal. To avoid a possible complication, a second caesarean section is needed.

Operational exposure is carried out with multiple pregnancy. The birth of two or more children may be accompanied by a risk to the life of the mother. Children may also have problems. Saving the life of the woman in labor and children is the main criterion when choosing the type of childbirth. For this reason, doctors resort to a surgical type of childbirth.

A caesarean section is performed when the child is in the wrong position in the uterine cavity. If the fetus has taken a transverse position or is located in the lower part of the uterus, an operation should be performed. Natural labor activity can cause fetal death. Death occurs when a child passes through the birth canal. Due to lack of oxygen, hypoxia occurs. The child is suffocating. To avoid death, it is necessary to carry out a section.

Also, the physiological structure of the pelvis can also be the cause. Bones before the approach of childbirth gradually move apart. The fruit is shifted to the bottom. But if the pelvis is narrow, then the child cannot move along the way. Prolonged stay of the fetus in the uterus without amniotic fluid can lead to death.

Relative reasons for the appointment of the operation

There are a number of relative reasons why a second caesarean section is performed. These reasons include the following pathologies:

Many women suffering from high myopia are scheduled for a second planned caesarean. The process of childbirth can be accompanied by strong attempts. Improper observance of attempts causes an increase in intraocular pressure. Women with myopia may lose their sight completely. Also, patients with myopia have problems with the vessels of the brain. Attempts also affect the state of the vascular system. To eliminate further complication of vision, the patient is recommended surgery.

Cancer is not always the reason for recommending a caesarean section. When assessing the condition of a woman, it is necessary to examine the neoplasm. If cancer cells multiply actively, then a woman should not give birth on her own. If the tumor does not develop, surgery can be avoided.

Diabetes causes various health problems in people. The disease has a negative impact on the condition of tissues and blood vessels. The walls of blood vessels become thinner. There is increased fragility of capillaries. During natural childbirth, excessive blood pressure on the walls of blood vessels can lead to rupture of the veins. This phenomenon is accompanied by blood loss. Blood loss leads to a serious deterioration in the condition of the mother. The risk of losing a child during childbirth increases. For diabetics, surgery is also dangerous. For this reason, the doctor needs to weigh all the positive and negative aspects of both types of childbirth. Only then can a decision be made.

Modern girls often face the problem of prolonged absence of pregnancy. Planning is delayed for several months. There are problems with conception and a second child. The onset of pregnancy can break at any time. To preserve the fetus, the woman undergoes maintenance therapy. Such medical intervention can affect the correct course of childbirth. Often there is a strong fixation of the fetus in the uterus. The patient needs stimulation of activity or section.

Sometimes there is a lack of labor activity. The mother's body does not respond to stimulation therapy. The process may not appear even after the bubble is punctured. In this case, the expansion of the cervix is ​​​​observed. If during the day the uterus does not open by 3-4 cm, it is necessary to perform an operation.

Timing of the surgery

The doctor calculates the average term of pre-delivery. The preliminary date of natural childbirth is set at the end of the 38th week of pregnancy. The normal period can vary from 38 to 40 weeks. With a caesarean section, the time of the PDR should be taken into account. It indicates the approximate time of the onset of natural labor. To prevent this, the operation is scheduled for the end of the 38th week.

At what time do the second caesarean section, many mothers ask. Secondary intervention is also carried out at the end of the 38th week. If there are additional indications for surgery or pregnancy has occurred less than three years after the last pregnancy, the section is carried out from 36 weeks.

Sometimes there are dangerous situations with the general condition of a woman. In this case, the secondary intervention is carried out at the time that allows you to save the life of the mother and child.

Characteristics of the surgical intervention

The section is carried out in two ways. The operation depends on the location of the incision. The following types of section are distinguished:

1. horizontal;
2. vertical.

The horizontal section is the most common form of surgery. During the operation, the suprapubic area is dissected. In this area, it has a fetal convergence of the muscular, epidermal and uterine layers. Such an incision avoids various forms of postoperative complications.

Vertical intervention is carried out according to medical indications. The incision is made from the bottom of the pubic bone to the top of the diaphragmatic muscles. With this type of operation, the doctor has access to the entire abdominal cavity. The healing of such an incision is more problematic.

Women who have undergone the procedure are interested in how a second caesarean section is done. In this case, the incision is made over the area of ​​the previous scar. This will prevent additional injuries to the uterine wall and preserve the appearance of the abdominal area.

Before the start of the operation, preparatory measures are taken. The woman must go to the hospital 2 days before the scheduled procedure. During this time, a complete study of the condition of the patient and the doctor is carried out. For the study of the patient, a sample of blood and urine is taken. If there is a suspicion of a bacterial infection, it is necessary to take a smear of the vaginal microflora. A day before the intervention, a special diet is prescribed, which allows the intestines to cleanse themselves. On this day, a cardiotographic examination of the fetus is performed. The device allows you to set the number of heartbeats of the child. 8 hours before the operation, the woman is forbidden to eat. For 2 hours, you should stop drinking.

The operation is simple. The average duration of the surgical intervention is 20 minutes. The time depends on the nature of the anesthesia. With full anesthesia, the woman is immersed in a state of sleep. The doctor puts his hand into the incision and pulls the child out by the head. After that, the umbilical cord is cut. The child is transferred to obstetricians. They assess the condition of the fetus on a ten-point scale. The doctor at this time removes the placenta and the remnants of the umbilical cord. The sutures are applied in reverse order.

If the second caesarean delivery is prescribed for the first time, then incomplete anesthesia can be performed. In this case, the woman can see the child, but pain is not felt.

Possible Complications

After a caesarean section, a variety of complications can occur. Often they occur with repeated intervention. The following types of probable pathologies are identified:

• development of the inflammatory process;
• bleeding;
• endometrial lesion;
• the appearance of adhesive tissue.

The development of the inflammatory process is observed against the background of fluid accumulation in the uterine cavity. Inflammation of the postoperative suture may also be observed. Bleeding is a common problem. Blood loss occurs against the background of severe inflammation. If it not stopped in a timely manner, the risk of death increases.

Sometimes there is another problem. It accompanies the vertical seam. The incision in this case is made between the diaphragmatic muscles. During the recovery period, prolapse of the rectum into the hernial orifice may occur. The hernia in this case develops rapidly.

Postoperative recovery

The second caesarean section requires a longer recovery period, which is important for patients to know. With the first surgical intervention, recovery occurs within one and a half months. The second intervention disables the body for two months.

Particular attention is paid to health in the first week after childbirth. The first day a woman should not eat food. It is allowed to drink water without gas. From the second day you can eat liquid food and rye unsalted crackers. Nutrition must be treated with special attention. If the food is not selected correctly, then constipation may occur. It is undesirable in the first month after the operation. You should also refrain from carrying heavy loads. The first week the patient should not carry the baby in her arms. Wearing weights is allowed on the 8th day after the removal of stitches.

Childbirth is a natural physiological process. But they are not always possible. If a doctor prescribes surgery, he has a reason for it. Therefore, one should not refuse to repeat the surgical intervention. It will keep the mother and child healthy.

It is not always recommended for a woman to give birth on her own. In the presence of a number of complications or features of the body, childbirth is carried out using a planned caesarean section. This method consists in the fact that the baby is brought into the light through an incision in the peritoneum and uterus. Such surgical intervention is used in almost a third of childbirth in the country. Some of them are carried out not because of the testimony of a doctor, but because of the unwillingness of mothers to endure pain during labor.

Indications for surgical intervention are divided into primary and secondary. The first are related to physiological causes. In this case, the need for a caesarean section is not even discussed. In the presence of secondary causes, the doctor decides whether an operation should be performed or whether childbirth can take place naturally. However, when a baby is born on its own, the risk of complications is high.

Main indications:

Secondary indications:

Types of caesarean section

There are two types of cesarean section: emergency and elective.

Scheduled caesarean section

In the absence of an urgent need for an operation and the normal state of the fetus, the first planned caesarean section is mainly carried out for a period of 39-40 weeks. By this time, the child is already fully formed and is able to breathe independently.

A second caesarean section is scheduled a couple of weeks earlier than this date. It is usually carried out at 38 weeks of pregnancy.

But there are cases when, as a result of emergency events, for example, premature detachment of the placenta, the doctor decides to perform the operation much earlier than the due date. Also, this can happen with a sharp deterioration in the condition of the woman in labor and her fetus. A caesarean section can be performed at 37, and even at 35 weeks. The fetus is not yet full-term, the lungs may also not be developed. A neonatologist examines the baby after birth, identifies problems with breathing, weight and pathologies, if any, and makes a decision for further actions with the baby. If necessary, the child is connected to an artificial lung ventilation system and power supply through a tube.

The duration of the operation is appointed by the surgeon approximately. A week before the birth, the expectant mother is hospitalized and undergoes all the necessary examinations. And only after receiving their data, the doctor appoints a specific date and time.

Advantages and disadvantages of the method

The undoubted advantage of a caesarean section is that it saves the lives of two people, while natural childbirth could lead to their death. Many mothers note the undoubted advantage of the operation is its speed. There is no need to spend long hours in the birthing chair, tormented by contractions. A quick operation will save the woman in labor from unbearable pain and will take only about half an hour. In this case, the child will be delivered to the light during the first 5-7 minutes. The rest of the time will take suturing. Also, this kind of birth of a baby saves the mother from the possibility of damage to the genitals.

Unfortunately, this method of giving birth to a child has many disadvantages. Those who believe that a caesarean section is an excellent way to have a quick and painless childbirth are deeply mistaken.

The main disadvantage of caesarean section is the appearance of various complications after the operation.

Placenta previa in subsequent births, the likelihood of removal of the uterus due to accrete placenta, internal scarring, heavy bleeding and inflammation in the uterus, complications with the healing of sutures - this is an incomplete list of what a woman can get as a result of childbirth by caesarean section.

Many mothers often complain that after such a birth they do not feel enough emotional connection with their child. They assume the wrongness of what is happening, and even become depressed. Thankfully it doesn't last long. Constant contact with the baby brings the mother back to normal. But the restriction in physical activity in the first time after childbirth, including lifting the baby in her arms, is a serious problem for a young mother. After the operation, it is difficult for her to provide proper care for the newborn. Therefore, at this time, more than ever, she needs the help of the household.

A difficult exit from anesthesia, weakness after surgery, an impressive scar, too, few women will be pleased. Abstinence from intimate life in the first months can be a serious test for a couple.

Caesarean section does not pass without a trace for the baby. With artificially induced childbirth, the baby may have remnants of amniotic fluid in the lungs, which is fraught with complications in the future. Inflammation of the lungs is not uncommon in newborns born as a result of caesarean section. Premature birth can also affect the baby's immunity and susceptibility to infections. Such children are easily susceptible to various diseases.

Before performing a caesarean section, the expectant mother must give her consent and choose the method of anesthesia. Everything is documented. Even if it is necessary to carry out emergency surgery directly during natural childbirth, the doctor must obtain the consent of the woman in labor.

If there are no special indications for the operation, medical workers recommend that women give birth on their own. But many naively choose a caesarean section, believing that they will get rid of painful and long contractions. But before signing the consent to the operation. You should carefully consider whether you are ready for the possible complications after such a birth? Maybe you should not risk your future health and give birth to your child without the intervention of a surgeon?

Video - caesarean section. School of Doctor Komarovsky

Caesarean section for the second time5.00 /5 (100.00%) Votes: 3

In many cases, during a second pregnancy, a mother-to-be who has had one caesarean section is set up in advance that surgery will be required for the birth of a second child. But the second caesarean section is not really necessary in all cases.. During the bearing of a second child, it is necessary to conduct a thorough examination, as a result of which a decision is made on the choice of the most appropriate method of delivery. All risks for mother and child must be weighed, and only after that the doctor can give his opinion on whether a second caesarean section is necessary. To make a decision and choose the tactics of conducting childbirth, the doctor must:

• Assess the scar on the uterus and its condition. If the scar tissue has not had time to form, then a decision is made on the second caesarean section. Therefore, if pregnancy occurs earlier than 2-3 years after the first birth, then surgery is really indispensable;
• Clarify how many pregnancies the woman had before, and what kind of caesarean section will be on the account. If two or more surgeries on the uterus have already been performed, then natural childbirth is considered impossible due to the high risk of uterine rupture. Before a third caesarean section, doctors may suggest tubal ligation along with surgery;
• Conduct an examination of the woman's condition. If serious diseases, due to which the first caesarean section was performed, were not cured, then a second caesarean section is indicated. The reason for carrying out a caesarean section for the second time may be the characteristics of the body that do not allow a woman to give birth on her own;
• Clarify whether there were abortions or other surgical procedures in the uterine area after cesarean section. For example, scraping significantly worsens the condition of the scar;
• Determine the location of the placenta: for the possibility of natural childbirth, it should not be in the area of ​​the scar;
• Clarify whether the pregnancy is singleton, as well as find out the features of the position of the fetus and its presentation. A multiple pregnancy is an indication for a second caesarean section, since the walls of the uterus are much more stretched, and the scar tissue becomes thin and functionally defective.

A second cesarean is also considered necessary if a longitudinal incision was made during the first birth. Such a scar is not consistent, but technically this intervention technique is much easier. Modern doctors usually make a transverse incision in the lower part of the uterus because such a scar is denser and less visible. If it is necessary to resort to a second caesarean section, the date of its implementation is postponed one to two weeks earlier than the predicted date of birth of the child. Most often, a second caesarean section is done at 38 weeks of gestation.

How is a second caesarean section performed?

The fact that the expectant mother had previously undergone a caesarean section is known to the doctor of the antenatal clinic or maternity hospital at the first visit of the pregnant woman. Its primary task is to identify indications for repeated operative delivery. The second birth after a caesarean section is carried out in a planned manner, but taking into account the fact that a second surgical operation is more difficult than the first caesarean section.

The dangers of a second caesarean section

If there is a need to perform a second caesarean section, the doctor must take into account that the first surgical intervention causes the development of an adhesive process in the small pelvis and the appearance of a scar on the uterus. Modern medicine does not provide an opportunity to avoid such a complication. In many cases, second births after caesarean section can be natural., while a second caesarean often results in bleeding from the uterus, which is very difficult to stop. Sometimes a doctor has to resort to removing the uterus to save a woman's life.

Surgical intervention also has a certain danger for the child: from the moment the operation begins until the baby is born, more time passes than during the first birth, and for a certain time it is subject to the influence of potent drugs.

For these reasons, modern doctors do not consider a second caesarean section as a mandatory method of delivery, and, depending on the specific situation, measures are taken to minimize the risks for the woman and the child.

The second caesarean section is the last

Many women are afraid to give birth on their own after the first caesarean section, even if there are no indications for repeated surgical intervention. As mentioned above, during the second caesarean section, doctors recommend that the woman be sterilized. Consequently, the refusal of independent childbirth leads to the impossibility of the birth of a third child. Pregnancy after a second caesarean section is too dangerous.

Caesarean section in recent years is so common that many simply forget that this is a serious operation that is fraught with complications. Despite the fact that it is now much safer than before, the risk of asphyxia of the newborn remains. During natural childbirth, all vital systems of the baby are quickly launched. With a second caesarean section, the date of which is scheduled before the onset of natural childbirth, this does not happen. Children born as a result of the operation experience some difficulties in adapting to the environment in the first few days of life.

Caesarean section in some cases leads to an increase in the incidence of a woman and the development of immunodeficiency. About a third of women after a second caesarean have complications such as urinary tract infections and inflammatory processes. Unfortunately, doctors rarely tell details about possible complications, on the contrary, they actively promote this method of delivery. This is partly due to the commercialization of medicine, which has been gaining momentum in the past few years. Since pregnancy after a second caesarean section can lead to serious complications, many women are advised to undergo surgical sterilization. Therefore, it is very important for expectant mothers to be informed in this matter.

The risk of uterine rupture during vaginal delivery after caesarean is very low in a normal pregnancy. Therefore, if there are no indications for a second caesarean section, you can agree with the doctor on the independent birth of a child. Of course, a thorough examination and constant supervision of a specialist is necessary, but if problems arise during childbirth, you can always resort to a caesarean section. Moreover, even in this case, the adaptation of the newborn will be much easier.

The main thing you need to know: the second birth after a caesarean section can be natural if there is no indication for surgery. Artificial stimulation during such childbirth is contraindicated, as is the use of painkillers. If there is the slightest threat to the life or health of the woman and child, a second caesarean section is performed.

The birth of a child is a function inherent in a woman by nature itself. However, sometimes it is necessary to intervene in this process in the most persistent way, saving the health (and sometimes life!) of the mother and baby. One of these measures is a caesarean section, which, although it is used as an emergency, is still not some kind of tragedy and does not put an end to the woman's reproductive system.

Is a second caesarean section necessary for the next pregnancy?

Any surgical intervention in such a complex system as the human body leaves a certain mark. Caesarean is not only not an exception, but rather an eloquent example. And it's not even a scar on the upper tissues and skin, but mainly in the broken integrity of the uterus. A repeated pregnancy, in which the walls of the uterus naturally stretch, can lead to rupture of the suture and tragic consequences. Therefore, if a second birth is planned after a cesarean section, then it is very desirable to schedule them at least two (or even three) years after this operation. During this period of time, the uterus should recover and strengthen its walls. In the event that a very short period has passed after the operation, the second caesarean section is predetermined.

Subject to the basic rules, contrary to popular belief, a woman has a good chance to give birth to a child in a natural way. That is, the inability to give birth on her own in the last pregnancy does not mean that the mother will certainly have a second caesarean section. The doctor makes the decision on the actual method of childbirth based on the analysis of many factors, and more and more specialists give preference, if possible, to natural childbirth.

Indications for a second caesarean section

In fact, there are not many good reasons for doctors to prescribe a caesarean section for the second time, but none of them tolerate being taken lightly. The most common indications:

• Diseases and conditions that carry a threat: diabetes mellitus, asthma, vision problems, hypertension (high blood pressure), recent traumatic brain injury, disorders of the cardiovascular and central nervous system, oncology;
• Excessively narrow or deformed pelvis;
• The outcome of the first cesarean - first of all, the state of the seam and its location;
• Features of the fetus itself - unfavorable position, large size, as well as multiple pregnancy;
• Overwearing, weak labor activity;
• Abortions after caesarean;
• Insignificant break between pregnancies;
• Mother's age after 30-35 years.

The right of the final decision remains with the woman, but it should not be abused. Doctors are not interested in any way in the emergence of a threat to the life of the patient, and therefore they try to resort to the safest option for the woman in labor.

Features of the reoperation

A caesarean section for the second time is unlikely to promise a pregnant woman any surprises, but there are still some differences. A second operation usually takes longer, since the incision is not made along the entire skin, but along a rougher area - along the old seam. Plus, a second caesarean section requires more caution due to increased risks. Therefore, anesthesia will also be stronger.

Another feature of the second caesarean section is the period at which it is carried out. Often, difficult pregnancies are sought to end as early as possible to eliminate the risks that threaten the mother or her baby. The longer and stronger the walls of the uterus are stretched, the higher the likelihood of its rupture. However, if there are no obvious causes for concern, then the operation is carried out as planned - at 37-39 weeks or even later. Usually, a pregnant woman is offered to go to the hospital a little in advance - for preservation.

The consequences of the second caesarean section

The recovery of the body will take a little longer than after the first cesarean, the same applies to the seam. A second operation can significantly harm the female reproductive system. Often there are violations of the menstrual cycle and even the impossibility of conception in the future, i.e. infertility. But some women manage to maintain their reproductive function, which, unfortunately, is also dangerous.

Pregnancy after a second caesarean section is associated with a number of serious risks to the health and life of the woman and the fetus. Therefore, doctors not only do not recommend patients with such a history to plan children again, but also suggest sterilization after the second cesarean section. Such fears and the precautions associated with them, although justified, are not mandatory. There are examples when mothers quite safely produced both the third and the fourth "caesar". But in fairness it should be noted that not all women can boast of such truly good health. Risk is, of course, a noble cause, but saving oneself for already born children is perhaps a higher mission.